Definitions
HRS §334B-2
in effect334B-2. Definitions
As used in this chapter:
"Director" means the director of
health.
"Health care provider" means any
person, corporation, facility, or institution licensed by this State to provide
health care services, including but not limited to a physician, hospital or
other health care facility, nurse, psychologist, or substance abuse counselor,
and officer, employee, or agent of such provider acting in the course and scope
of employment or agency related to health care services.
"Health care services" means
diagnosis, treatment, medical or psychological evaluation or advice, or other
acts as permissible under the health care licensing statutes of this State.
"Physician" means a person licensed
to practice medicine under chapter 453.
"Psychologist" means a person
licensed to practice psychology under chapter 465.
"Review agent" means a hospital or
nonhospital-affiliated person or entity performing utilization review or
managed care that is either affiliated with, under contract with, or acting on
behalf of:
(1) A business entity in this State; or
(2) A third party that provides or administers
hospital, medical, psychological, or other health care benefits to citizens of
this State, including a health insurer, nonprofit health service plan, health
insurance service organization, health maintenance organization, or preferred
provider organization authorized to offer health insurance policies or
contracts in this State.
"Utilization review" or "managed
care" means a system for reviewing the appropriate and efficient
allocation of mental health, alcohol, or drug abuse treatment services given or
proposed to be given to a patient or group of patients for the purpose of
recommending or determining whether such services should be reimbursed,
covered, or provided by an insurer, plan or other entity or person.
"Utilization review plan" means a
description of the criteria and standards governing utilization review or
managed care activities performed by a review agent.
[L 1991, c 95, pt of §1]
Source: Hawaii State Legislature (capitol.hawaii.gov), via Internet Archive capturesURL: http://www.capitol.hawaii.gov/hrscurrent/Vol06_Ch0321-0344/HRS0334B/HRS_0334B-0002.htmFetched: 11/10/2026